EAST TENNESSEE STATE UNIVERSITY

NPI # 

Practice Address:

2151 Century Lane

Johnson City, TN, 37604

Practice Phone:

423-926-2500

Practice Fax:

423-926-5999

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X